'Madness: A Bipolar Life' casts light on shadows

Marya Hornbacher, at her home in Minneapolis, has published a memoir about her lifelong bipolar disorder. She says she's at equilibrium "much of the time."

MINNEAPOLIS  Marya Hornbacher remembers her "endless nights" as a child as young as 4, when she says she first began to show symptoms of bipolar disorder.

"Bam! At 5, 6 o'clock I'm off, I'm ready to roll. And the world is shutting down around me and I'm getting more and more frantic because nobody wants to talk," Hornbacher recalls with a laugh, "and nobody else wants to go to the moon that afternoon and nobody else wants to go ice skating in the woods, you know, at 4 a.m."

She would spin out of control, racing around the house until her mother discovered that a late-night bath would calm her. Finally, she says, her parents told her she could do anything she wanted at night, "but you cannot come out of your room and talk to us, because we're going to bed."

Hornbacher, now 34, says those early episodes were the start of a lifelong cycle of mania that culminated in repeated hospitalizations, electroshock treatments and eventually daily medication that stabilizes her mood.

After chronicling her battle with eating disorders in her 1998 memoir "Wasted," Hornbacher tackles her alternating bouts of euphoria and depression in a new book, "Madness: A Bipolar Life." Reviews have been positive, with USA Today saying that as Hornbacher "whips around this roller-coaster ride, her unflinching style keeps us seated firmly beside her."

Writing in a straightforward narrative, Hornbacher fills "Madness" with grim details, such as the time in 1994 she slashed open her left arm while cutting herself as a 20-year-old. She recounts spending sprees, failed romances and her haziness after electroconvulsive therapy (ECT). But she also writes with humor about stuffing a brocade bedspread into a too-small washer during a cleaning frenzy.

Dressed stylishly with her hair dyed red and cut short, Hornbacher appeared upbeat during an interview at the comfortable house she shares with her second husband, Jeff Miller, two miniature dachshunds (Dante and Milton) and two cats (Shakespeare and T.S. Eliot). Thanks to her medication  she takes around 26 pills a day  and basic daily tasks, Hornbacher is at equilibrium "much of the time."

But her impulses  such as to suddenly travel a great distance or go shopping  can trigger a manic episode.

Bipolar disorder, formerly known as manic depression, affects as many as 5.8 million American adults each year, or 2.6 percent of the U.S. population age 18 and older, with 25 the median age of onset, according to the National Institute of Mental Health (NIMH). Hornbacher writes that she was diagnosed with bipolar in 1997 and is bipolar I, spending more of her time manic before going into an occasional "vicious" depression, than the milder bipolar II.

A recovering alcoholic who has been sober for years, Hornbacher writes that despite her bipolar diagnosis, she would continue to drink, which negated the effects of her medication.

Patients with bipolar have a high rate of substance abuse and may turn to alcohol or drugs for self-medication, according to Dr. Husseini Manji, head of the Mood and Anxiety Disorders program at the NIMH.

"One possibility is that people who are not feeling good  who are depressed or high or irritable  need to do something about it. One of the things in our society you can access is alcohol, or some illicit drugs," Manji said.

Hornbacher believes she may have "had the seeds of a mental illness" as a child and that her sleeplessness may have tripped chemical changes in her brain. (An insomniac, she says she only sleeps four or five hours a night now but tries to make up for it with catnaps during the day.)

"You become manic once, it feeds on itself. The less you sleep, the less you sleep. The only problem is, without a tranquilizer, my parents couldn't have knocked me out. And so they're just trying to contain the situation I'm already in," Hornbacher says of growing up.

Raising Marya (pronounced MAR'-yah) was challenging, but the idea that she was bipolar  a term that wasn't used until 1980  was "totally alien" to her mother, Judy Hornbacher.

"It wasn't like she was biting people or hitting," Judy Hornbacher says, although she remembers a birthday party where her daughter got so excited she stripped off all her clothes. She said Marya's struggle with bipolar "has not ruined our relationship at all" and that she remains close to her daughter.

"She's my hero, I will tell you that, because of her resilience and will," Judy Hornbacher said.

Marya Hornbacher says she has about four episodes a year and was last hospitalized last summer. She says she occasionally has grandiose delusions  "I did think I was a Supreme Court justice at one time"  and that reminding herself of her accomplishments doesn't help.

"Telling myself what I've done, how well I've done, when I'm manic, and saying, 'Well, it is enough to just be a best-selling author, you don't need to be queen.' It's not that I feel a desire to be queen. It's that one day, I think I'm queen," Hornbacher said.

Hornbacher accepts that she eventually will be hospitalized again and says there is no stigma to it.

"Were I to put myself on ... one of those online dating things, I would not include in my profile that I'm regularly hospitalized for psychosis," she said. "But I do know that when I get really bad, there is a place for me to go where I will feel better."